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RLS and Rheumatoid Arthritis

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To all:

It has been said that rheumatoid arthritis (RA) is a documented

secondary cause of RLS. It is true that some people with RA get RLS

and some people with RLS get RA. There are many papers by good workers

that include RA in their list of diseases causing secondary RLS.

However, if one looks at the bibliographies of these papers, one would

find that they are all referring to the same single article as the

basis for their including RA. This article appeared in 1994 in the

British Journal of Rheumatology and describes RLS symptoms in 25% of

the RA patients studied. However, 9 of 14 of the patients with RLS

that were tested showed neurological findings of either spinal cord

disease or peripheral neuropathy. Disease of the spinal cord and

peripheral neuropathy are accepted causes for secondary RLS. The

authors state that " these data suggest that RLS symptoms in RA

patients may reflect the presence of neurological disorder. " So, I

think that it is fairer to say that if a person has rheumatoid

arthritis with neurological involvement, they are more likely to have

RLS symptoms rather than include all people with RA. RA and RLS are

very common diseases and the presence of coincidental disease could

explain the majority of the other patients having both RA and RLS. A

literature search revealed no other papers dealing with this

association. It is not unusual for medical paper authors to just copy

bibliographies from previous papers without reading the cited articles

themselves. One is expected to read the cited papers, but it doesn't

always happen. Thus we have one paper which has been cited over and

over again by various authors which really doesn't make a strong case

that RA is a frequent cause of secondary RLS, unless nerve damage is

present. No studies have been done to determine the incidence of RLS

in RA patients who do not have nerve damage.

Dr. Levin

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